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    Clinical Trial Results:
    Long-Term Extension, Open-Label Study of Atomoxetine Hydrochloride in Child Outpatients With Attention-Deficit/Hyperactivity Disorder

    Summary
    EudraCT number
    2017-000686-68
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    01 Aug 2009

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Dec 2021
    First version publication date
    22 Dec 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    B4Z-JE-LYDA
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00191386
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    Trial Number: 9315
    Sponsors
    Sponsor organisation name
    Eli Lilly and Company
    Sponsor organisation address
    Lilly Corporate Center, Indianapolis, IN, United States, 46285
    Public contact
    Available Mon ‐ Fri 9 AM ‐ 5 PM EST, Eli Lilly and Company, 1 877‐CTLilly,
    Scientific contact
    Available Mon ‐ Fri 9 AM ‐ 5 PM EST, Eli Lilly and Company, 1 877‐285‐4559,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    01 Aug 2009
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    01 Aug 2009
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate long-term safety and efficacy of Atomoxetine in Japanese pediatric patients with Attention-Deficit/Hyperactivity Disorder (AD/HD).
    Protection of trial subjects
    This study was conducted in accordance with International Conference on Harmonization (ICH) Good Clinical Practice, and the principles of the Declaration of Helsinki, in addition to following the laws and regulations of the country or countries in which a study is conducted.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 May 2005
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Japan: 228
    Worldwide total number of subjects
    228
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    228
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study was as a follow-up investigation of ADHD pediatric patients who completed Study LYBC (NCT00191295).

    Pre-assignment
    Screening details
    Not Applicable

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Atomoxetine
    Arm description
    0.5 milligrams per kilogram (mg/kg) twice daily (BID), orally (PO) titrated to 1.2 mg/kg BID, PO over 2 weeks then 1.2 to 1.8 mg/kg BID, PO for 6 months and up to 4 years
    Arm type
    Experimental

    Investigational medicinal product name
    Atomoxetine
    Investigational medicinal product code
    Other name
    LY139603; Strattera
    Pharmaceutical forms
    Capsule, hard
    Routes of administration
    Oral use
    Dosage and administration details
    0.5 milligrams per kilogram (mg/kg) twice daily (BID), orally (PO) titrated to 1.2 mg/kg BID, PO over 2 weeks then 1.2 to 1.8 mg/kg BID, PO for 6 months and up to 4 years.

    Number of subjects in period 1
    Atomoxetine
    Started
    228
    6 Months
    183
    12 Months
    149
    2 Years
    105
    3 Years
    65 [1]
    Completed
    68
    Not completed
    160
         Consent withdrawn by subject
    96
         Physician decision
    11
         Adverse event, non-fatal
    16
         Entry Criteria Exclusion
    3
         Lost to follow-up
    1
         Protocol deviation
    18
         Lack of efficacy
    15
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: These are patients who continued in optional open-label period (1 country). All received atomoxetine

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Atomoxetine
    Reporting group description
    0.5 milligrams per kilogram (mg/kg) twice daily (BID), orally (PO) titrated to 1.2 mg/kg BID, PO over 2 weeks then 1.2 to 1.8 mg/kg BID, PO for 6 months and up to 4 years

    Reporting group values
    Atomoxetine Total
    Number of subjects
    228 228
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    10.69 ± 2.48 -
    Gender categorical
    Units: Subjects
        Female
    33 33
        Male
    195 195
    Race/Ethnicity, Customized
    Units: Subjects
        East Asian
    228 228
    Region of Enrollment
    Units: Subjects
        Japan
    228 228
    ADHD Rating Scale-IV-Translated in Japanese Parent Version: Investigator Administered/Scored
    Measures the 18 symptoms contained in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR) diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Individual item scores range from 0 (none/never or rarely) to 3 (severe/very often). Total scores range from 0 to 54.
    Units: Units on a scale
        arithmetic mean (standard deviation)
    22.23 ± 10.42 -

    End points

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    End points reporting groups
    Reporting group title
    Atomoxetine
    Reporting group description
    0.5 milligrams per kilogram (mg/kg) twice daily (BID), orally (PO) titrated to 1.2 mg/kg BID, PO over 2 weeks then 1.2 to 1.8 mg/kg BID, PO for 6 months and up to 4 years

    Primary: Number of Participants With Adverse Events for Long Term Safety and Tolerability

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    End point title
    Number of Participants With Adverse Events for Long Term Safety and Tolerability [1]
    End point description
    Details on the actual adverse events are presented in the Reported Adverse Events Section.
    End point type
    Primary
    End point timeframe
    Baseline through 4 years
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis planned for this outcome.
    End point values
    Atomoxetine
    Number of subjects analysed
    228
    Units: Participants
    number (not applicable)
        Serious Adverse Events
    6
        All Other Nonserious Adverse Events
    222
    No statistical analyses for this end point

    Secondary: Change From Baseline at Various Timepoints in Attention Deficit Hyperactivity Disorder Rating Scale-IV-Translated in Japanese Parent Version: Investigator Administered and Scored (ADHDRS-IV-J:I) Total Score

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    End point title
    Change From Baseline at Various Timepoints in Attention Deficit Hyperactivity Disorder Rating Scale-IV-Translated in Japanese Parent Version: Investigator Administered and Scored (ADHDRS-IV-J:I) Total Score
    End point description
    Measures the 18 symptoms contained in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR) diagnosis of Attention-Deficit/Hyperactivity Disorder. Individual item scores range from 0 (none/never or rarely) to 3 (severe/very often). Total scores range from 0 to 54.
    End point type
    Secondary
    End point timeframe
    Baseline, 6 Months, 12 Months, 2 Years, 3 Years, 4 Years
    End point values
    Atomoxetine
    Number of subjects analysed
    228
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Total Score 6 Months (n=228)
    -14.1 ± 9.3
        Total Score 12 Months (n=178)
    -16.0 ± 9.2
        Total Score 2 Years (n=143)
    -17.7 ± 9.4
        Total Score 3 Years (n=105)
    -20.0 ± 9.2
        Total Score 4 Years (n=62)
    -20.1 ± 10.5
    No statistical analyses for this end point

    Secondary: Change From Baseline at Various Timepoints in the Clinical Global Impressions-Attention Deficit Hyperactivity Disorder-Severity (CGI-ADHD-S)

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    End point title
    Change From Baseline at Various Timepoints in the Clinical Global Impressions-Attention Deficit Hyperactivity Disorder-Severity (CGI-ADHD-S)
    End point description
    Measures severity of the participant's overall severity of ADHD symptoms (1=normal, not at all ill; 7=among the most extremely ill patients).
    End point type
    Secondary
    End point timeframe
    Baseline, 6 Months, 12 Months, 2 Years, 3 Years, 4 Years
    End point values
    Atomoxetine
    Number of subjects analysed
    228
    Units: Units on a scale
    arithmetic mean (standard deviation)
        6 Months
    -1.1 ± 1.1
        12 Months
    -1.3 ± 1.1
        2 Years
    -1.4 ± 1.0
        3 Years
    -1.6 ± 1.0
        4 Years
    -1.8 ± 1.1
    No statistical analyses for this end point

    Secondary: Cytochrome P450 2D6 (CYP2D6) Phenotype Status

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    End point title
    Cytochrome P450 2D6 (CYP2D6) Phenotype Status
    End point description
    Participants were categorized as either extensive metabolizers (EM) or poor metabolizers (PM). CYP2D6 is the primary atomoxetine metabolizing enzyme. The CYP2D6 genotype were analysed by testing the *2, *3, *4, *5, *6, *7, *8, and *10 alleles. Metabolizer status was determined by focusing on the normal(wild type, *2), decreased(*10), and defective allele(*3, *4, *5, *6, *7, or *8). PM were assigned to the patients had two defective alleles in any combination of *3, *4, *5, *6, *7, or *8 alleles. EM was all except for PM.
    End point type
    Secondary
    End point timeframe
    Over 1 year
    End point values
    Atomoxetine
    Number of subjects analysed
    228
    Units: Participants
    number (not applicable)
        Extensive Metabolizer
    225
        Poor Metabolizer
    3
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Entire Study
    Adverse event reporting additional description
    B4Z-JE-LYDA
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    12.0
    Reporting groups
    Reporting group title
    atomoxetine
    Reporting group description
    -

    Serious adverse events
    atomoxetine
    Total subjects affected by serious adverse events
         subjects affected / exposed
    6 / 228 (2.63%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    eye injury
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    1 / 228 (0.44%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    asthma
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    1 / 228 (0.44%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    hepatic function abnormal
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    1 / 228 (0.44%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    schizophrenia
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    1 / 228 (0.44%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    thyroiditis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    1 / 228 (0.44%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    pneumonia mycoplasmal
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    1 / 228 (0.44%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    atomoxetine
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    222 / 228 (97.37%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    skin papilloma
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    13 / 228 (5.70%)
         occurrences all number
    17
    Injury, poisoning and procedural complications
    arthropod sting
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    18 / 228 (7.89%)
         occurrences all number
    41
    contusion
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    30 / 228 (13.16%)
         occurrences all number
    51
    excoriation
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    17 / 228 (7.46%)
         occurrences all number
    30
    fall
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    18 / 228 (7.89%)
         occurrences all number
    26
    joint sprain
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    22 / 228 (9.65%)
         occurrences all number
    30
    Surgical and medical procedures
    tooth extraction
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    14 / 228 (6.14%)
         occurrences all number
    22
    Nervous system disorders
    headache
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    67 / 228 (29.39%)
         occurrences all number
    173
    somnolence
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    34 / 228 (14.91%)
         occurrences all number
    37
    General disorders and administration site conditions
    malaise
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    14 / 228 (6.14%)
         occurrences all number
    20
    pyrexia
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    34 / 228 (14.91%)
         occurrences all number
    43
    Eye disorders
    conjunctivitis allergic
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    13 / 228 (5.70%)
         occurrences all number
    17
    myopia
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    12 / 228 (5.26%)
         occurrences all number
    13
    Gastrointestinal disorders
    abdominal pain
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    53 / 228 (23.25%)
         occurrences all number
    106
    constipation
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    17 / 228 (7.46%)
         occurrences all number
    25
    dental caries
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    23 / 228 (10.09%)
         occurrences all number
    24
    diarrhoea
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    42 / 228 (18.42%)
         occurrences all number
    58
    nausea
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    28 / 228 (12.28%)
         occurrences all number
    47
    stomatitis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    20 / 228 (8.77%)
         occurrences all number
    27
    toothache
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    12 / 228 (5.26%)
         occurrences all number
    12
    vomiting
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    29 / 228 (12.72%)
         occurrences all number
    45
    Respiratory, thoracic and mediastinal disorders
    cough
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    22 / 228 (9.65%)
         occurrences all number
    27
    epistaxis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    22 / 228 (9.65%)
         occurrences all number
    55
    oropharyngeal pain
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    12 / 228 (5.26%)
         occurrences all number
    14
    rhinitis allergic
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    22 / 228 (9.65%)
         occurrences all number
    30
    upper respiratory tract inflammation
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    49 / 228 (21.49%)
         occurrences all number
    139
    Skin and subcutaneous tissue disorders
    eczema
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    21 / 228 (9.21%)
         occurrences all number
    29
    urticaria
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    12 / 228 (5.26%)
         occurrences all number
    24
    Infections and infestations
    bronchitis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    23 / 228 (10.09%)
         occurrences all number
    39
    gastroenteritis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    36 / 228 (15.79%)
         occurrences all number
    53
    gastroenteritis viral
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    18 / 228 (7.89%)
         occurrences all number
    25
    impetigo
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    15 / 228 (6.58%)
         occurrences all number
    17
    influenza
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    55 / 228 (24.12%)
         occurrences all number
    62
    nasopharyngitis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    127 / 228 (55.70%)
         occurrences all number
    420
    otitis media
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    12 / 228 (5.26%)
         occurrences all number
    14
    pharyngitis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    26 / 228 (11.40%)
         occurrences all number
    46
    rhinitis
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    17 / 228 (7.46%)
         occurrences all number
    31
    Metabolism and nutrition disorders
    decreased appetite
    alternative dictionary used: MedDRA 12.0
         subjects affected / exposed
    30 / 228 (13.16%)
         occurrences all number
    36

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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